The patient‘s metabolic disease, such as osteoporosis, diabetes, gout, etc., impedes the osteointegration of the or-thopedic implant. Based on the pathological features of the bone environment in fracture sites, developing novel biologic coatings on orthopedic implants, including anti-oxidative coating for osteoporosis, anti-bacterial coating for diabetes and im-mune-modulation coating for gout, is an effective way to enhance the osteointegration. To investigate the effects of orthopedic implant bio-coatings on cells which affect the pathological environment, and to summarize the relationship among surface char-acteristics and cellular behaviors and bone formation can provide a basis for the design of new orthopedic implant bio-coatings. Plasma sprayed ceria-based coatings with anti-oxidative properties can decompose excessive reactive oxygen species in living organisms by catalytic, and protect the osteogenic differentiation of osteoblasts from the negative effects of oxidative stress, which is beneficial for the osteointegration in osteoporosis. Calcium silicate-based bio-coatings with anti-infective and osteogenic functions can reduce the chance of implant-associated infection by inhibiting adhesion and growth of bacteria on their surface. In addition, this type of coating can also promote osteogenic differentiation and mineralization of osteoblasts and improve the osteointegration, exhibiting the potential to be applied to patients with fractures and diabetes. The micro/nano hierarchical structured Ti coatings and Sr/B/Ce modified bio-coatings demonstrate osteoimmune-modulation property and the improvement in osteoblastic differentiation, indicating that they can be used as bone repair materials under inflammatory diseases.